Concordance of health states in couples: Analysis of self-reported, nurse administered and blood-based biomarker data in the UK Understanding Society panel

Apostolos Davillas,Stephen Pudney

doi:10.1016/j.jhealeco.2017.09.010

Abstract

We use self-reported health measures, nurse-administered measurements and blood-based biomarkers to examine the concordance between health states of partners in marital/cohabiting relationships in the UK. A model of cumulative health exposures is used to interpret the empirical pattern of between-partner health correlation in relation to elapsed relationship duration, allowing us to distinguish non-causal correlation due to assortative mating from potentially causal effects of shared lifestyle and environmental factors. We find important differences between the results for different health indicators, with strongest homogamy correlations observed for adiposity, followed by blood pressure, heart rate, inflammatory markers and cholesterol, and also self-assessed general health and functional difficulties. We find no evidence of a “dose–response relationship” for marriage duration, and show that this suggests – perhaps counterintuitively – that shared lifestyle factors and homogamous partner selection make roughly equal contributions to the concordance we observe in most of the health measures we examine.

Highlights

Research on the health of couples is sparse relative to research on individuals, twins and siblings (Meyler et al, 2007)
To understand the health of couples, it is important to distinguish homogamy and causal concordance
We show that the mean health state of each partner j when observed at time T is a potentially nonlinear function of age aj so that it is appropriate to use an age-adjusted form of each health indicator as a residual after extracting a nonparametric estimate of the health-age profile

Summary

Introduction

Research on the health of couples is sparse relative to research on individuals, twins and siblings (Meyler et al, 2007). To understand the health of couples, it is important to distinguish homogamy (a tendency for people to choose partners similar to themselves) and causal concordance (correlation of health states caused by lifestyle and environmental influences shared within the marriage).. Empirical evidence suggests that matching processes are multidimensional and not driven by a single individual characteristic (Chiappori et al, 2012). Health (more observable health dimensions) may be a matching criterion itself, it is more likely that health selection arises from indirect selections through other characteristics, such as behaviours, age, education and socio-economic position (Chiappori et al, 2012; Clark and Etilé, 2006)

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